AUTHOR=Dessale Mesfin , Mengistu Getachew , Mengist Hylemariam Mihiretie 

TITLE=Prevalence, antimicrobial resistance pattern, and associated factors of Salmonella and Shigella among under five diarrheic children attending public health facilities in Debre Markos town, Northwest Ethiopia

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1114223

DOI=10.3389/fpubh.2023.1114223

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p>Under five children are at risk of diarrhea-associated morbidity and mortality. <italic>Salmonella</italic> and <italic>Shigella</italic> are major causes of diarrhea in under-five children, especially in developing countries. This study aimed to assess the prevalence, antimicrobial resistance pattern, and associated factors of <italic>Salmonella</italic> and <italic>Shigella</italic> among under-five diarrheic children in Debre Markos town public health facilities.</p></sec><sec><title>Methods</title><p>A cross-sectional study was conducted at public health facilities in Debre Markos town using a consecutive convenient sampling technique. Data on socio-demographic and associated factors were collected using a structured questionnaire. <italic>Salmonella</italic> serovars and <italic>Shigella</italic> species were identified using MacConkey, Xylose Lysine Deoxycholate, <italic>Salmonella Shigella</italic> agar, and biochemical tests. The antimicrobial resistance pattern was determined by using the modified Kirby-Bauer disk diffusion technique.</p></sec><sec><title>Results</title><p>The overall prevalence of <italic>Salmonella</italic> and <italic>Shigella</italic> was 11.7% (26/222; 95% CI = 7.2–17.5%). Isolated <italic>Salmonella</italic> serovars showed a higher rate of resistance (85.7%, 6/7) for both Ampicillin and Amoxicillin/Clavulanic acid while <italic>Shigella</italic> isolates showed a higher resistance rate to Amoxicillin/Clavulanic acid (78.9%, 15/19) and Ampicillin (73.7%, 14/19). The overall multidrug resistance (MDR) rate of <italic>Salmonella</italic> and <italic>Shigella</italic> isolates was 88.5% (23/26). Parent/guardian educational status ≤ elementary school (AOR = 3.783; 95% CI = 1.28–11.19; <italic>P</italic> = 0.016), presence of two or more under-five children in the family (AOR = 8.999; 95% CI = 2.93–27.69; <italic>P</italic> &lt; 0.001), unimproved source of drinking water (AOR = 5.010; 95% CI = 1.56–16.10; <italic>P</italic> = 0.007), the habit of storing cooked foods for later use (AOR = 3.199; 95% CI = 1.07–9.54; <italic>P</italic> = 0.037), attendance of the child at social gatherings (AOR = 5.387; 95% CI = 1.78–16.35; <italic>P</italic> = 0.003), and infrequent child fingernail trimming (every ≥ 2 weeks; AOR = 4.693; 95% CI = 1.47–14.94; <italic>P</italic> = 0.009) showed statistically significant association with the prevalence of culture-confirmed <italic>Salmonella</italic> and <italic>Shigella</italic> isolates.</p></sec><sec><title>Conclusion</title><p>The prevalence of culture-confirmed <italic>Salmonella</italic> and <italic>Shigella</italic> isolates was significantly high in the study area. <italic>Salmonella</italic> and <italic>Shigella</italic> isolates exhibited a high rate of MDR pattern. Parent/guardian education level below the elementary school, the presence of two or more under-five children in the family, using unimproved water source, a habit of storing cooked food, and infrequent fingernail trimming were independent predictors of culture-confirmed <italic>Salmonella</italic> and <italic>Shigella</italic>. Therefore, besides public health measures, regular surveillance of the prevalence and antimicrobial resistance pattern of <italic>Salmonella</italic> and <italic>Shigella</italic> should be routinely practiced in the study setting.</p></sec>